Injuries/Violence
Trends in Non-Fatal Self-Harm Injury by Age, Sex, and Race and Ethnicity among Adolescents in California, 2005 to 2021 Emily F. Liu* Emily Liu Ellicott C. Matthay Kriszta Farkas Jennifer Ahern
Adolescent girls experience a higher burden of non-fatal self-harm and greater increases over time when compared to adolescent boys. Sex, age, and race and ethnicity are important dimensions of social identity and intersect to shape exposure to risk factors for self-harm. However, trends in self-harm within these subgroups have not been examined.
We analyzed statewide inpatient and emergency department hospital discharge data from California 2005-2021 among younger (aged 10-14 years) and older (aged 15-19 years) adolescents. Self-harm incidents were identified using diagnostic codes and rates were calculated per 100,000 person-years based on census data.
From 2005-2021, the self-harm rate among adolescents rose from 191.0 to 453.2 per 100,000 person-years, with larger increases among girls (281 to 729.7) than boys (105.2 to 187.10). In 2005, White girls aged 15-19 years experienced the highest self-harm rate at 635.1 per 100,000 person-years. After 2016, self-harm rates increased sharply among Multiracial adolescents. By 2021, the self-harm rate was still highest among older adolescent girls, but Multiracial girls now experienced the highest rate (1330.0), followed by White (1201.6) and Black girls (1069.7). American Indian, Hispanic, and Asian/Pacific Islander girls had lower self-harm rates of 809.5, 582.8, and 439.9 per 100,000 person-years, respectively. Among boys, high rates and substantial increases among Multiracial and American Indian youth were notable.
This study reveals striking differences in trends in adolescent self-harm across race and ethnicity groups. Further research is needed to examine whether these trends are driven by increasing exposure to self-harm risk factors and/or changes in how adolescents identify with race and ethnicity groupings. Caregivers, clinicians, and teachers should be aware of the alarming increases and racial and ethnic patterns in self-harm and play an active role in supporting adolescent mental health to reduce self-harm.
